Surgical instruments and method for corneal reformation

Abstract

A surgical method of corneal reformation reduces the risk of trauma and shortens overall recovery while yielding improved visual acuity includes making a relatively shallow incision of no more than about 85 microns deep into the corneal epithelium, separating the corneal epithelial sheet from the underlying Bowman's Membrane using an epithelial separator or a specialized cannula, and lifting the epithelial sheet away from the ablation zone so that the Bowman's Membrane and underlying stromal bed can be reformed. Multiple surgical instruments include the optional use of vibration with an epithelial separator or cannula to separate an epithelial sheet from the cornea of no more than about 85 microns thick.

1. A surgical instrument for use in corneal reconstruction, comprising:
 a connecting end; and 
 a hollow spatula-like member having a proximal end supported by said connecting end and a distal tip opposite said proximal end, said spatula-like member including an arcuate distal section formed in a plane along a curvature, and further including a fluid passageway therein, said fluid passageway being in fluid communication with a fluid source, with one side of said spatula-like member further including a plurality of apertures wherefrom fluid from said fluid source may be ejected, 
 wherein said spatula-like member has a trapezoidal cross-sectional shape, and 
 wherein said surgical instrument is adapted to separate corneal surface epithelium from the underlying cornea. 
 
   
   
     2. The surgical instrument of  claim 1  wherein said distal tip includes an aperture whereby fluid from said fluid source may be ejected onto the cornea. 
   
   
     3. The surgical instrument of  claim 1  wherein said fluid source is a syringe connected to said connecting end. 
   
   
     4. The surgical instrument of  claim 1  wherein said spatula-like member has a height of no greater than about 0.5 millimeters. 
   
   
     5. The surgical instrument of  claim 1  wherein said distal section has a length of about 10 millimeters to about 15 millimeters. 
   
   
     6. The surgical instrument of  claim 1  wherein there are 15 to 25 apertures. 
   
   
     7. The surgical instrument of  claim 1  wherein the diameter of said apertures ranges from about 0.05 millimeters to 0.10 millimeters. 
   
   
     8. The surgical instrument of  claim 1  wherein the apertures are evenly spaced about 0.4 millimeters apart along said side. 
   
   
     9. The surgical instrument of  claim 1  wherein said distal section curvature has a radius of curvature between about 8 millimeters and about 12 millimeters. 
   
   
     10. The surgical instrument of  claim 1  wherein said proximal end is oriented with respect to the distal section to form a vertical angle of about 40 degrees to about 60 degrees. 
   
   
     11. The surgical instrument of  claim 1  wherein said trapezoidal spatula-like member has a top side and an opposing contact side, said top side having a width of about 0.5 millimeters to about 1.0 millimeters, and said contact side having a width of about 0.75 millimeters to about 1.25 millimeters. 
   
   
     12. The surgical instrument of  claim 1  wherein said distal section curvature has a radius of curvature between about 8 millimeters and about 11.5 millimeters.